Postoperative complications and survival of elderly breast cancer patients: a FOCUS study analysis

Glas, Nienke A. de; Kiderlen, M.; Bastiaannet, E.; Craen, Anton J. M. de; Water, W. van de; Velde, Cornelis J.H. van de; Liefers, Gerrit‐Jan

doi:10.1007/s10549-013-2462-9

Cited by 101 publications

(108 citation statements)

References 20 publications

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“…Women in poor health or with severe comorbid conditions and limited life expectancy may also be more vulnerable to harms of screening, including anxiety and discomfort associated with additional testing, 83–85 and risk of overdiagnosis (due to increased risk of dying from non-breast-cancer related causes) as well as to harms from breast cancer treatment. 86–88 Thus, health and life expectancy, not simply age, must be considered in screening decisions.…”

Section: Results (Recommendations)mentioning

confidence: 99%

Breast Cancer Screening for Women at Average Risk

Oeffinger

Fontham

Etzioni

et al. 2015

JAMA

1,398

906

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Importance Breast cancer is a leading cause of premature mortality among U.S. women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality. This report updates the American Cancer Society (ACS) 2003 breast cancer screening guideline for women at average risk for breast cancer. Process The ACS commissioned a systematic evidence review of the breast cancer screening literature to inform the update, and a supplemental analysis of mammography registry data to address questions related to the screening interval. Formulation of recommendations was based on the quality of the evidence and judgment (incorporating values and preferences) about the balance of benefits and harms. Evidence Synthesis Mammography screening in women aged 40–69 years is associated with a reduction in breast cancer deaths across a range of study designs, and inferential evidence supports breast cancer screening in women who are age 70 years and older and are in good health. Estimates of the cumulative lifetime risk of false positive exams are greater if screening begins at younger ages due to the greater number of mammograms, as well as the higher recall rate in younger women. The quality of the evidence for overdiagnosis is not sufficient to estimate a lifetime risk with confidence. Analysis examining the screening interval demonstrates more favorable tumor characteristics when premenopausal women are screened annually vs. biennially. Evidence does not support routine clinical breast examination as a screening method for average risk women. Recommendations The ACS recommends that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years (strong recommendation). Women who are ages 45 to 54 years should be screened annually (qualified recommendation). Women who are age 55 years and older should transition to biennial screening or have the opportunity to continue screening annually (qualified recommendation). Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (qualified recommendation). Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or more (qualified recommendation). The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age (qualified recommendation).

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Section: Results (Recommendations)mentioning

confidence: 99%

Breast Cancer Screening for Women at Average Risk

Oeffinger

Fontham

Etzioni

et al. 2015

JAMA

1,398

906

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“…All presented Relative Excess Risks (RERs) are adjusted for age at diagnosis, oestrogen-receptor/progesteron-receptor (ER/PR) status, morphology, grade and number of metastatic sites. [19][20][21]. This requires good selection of patients for specific treatments [18].…”

Section: Discussionmentioning

confidence: 99%

Survival of older patients with metastasised breast cancer lags behind despite evolving treatment strategies – A population-based study

Glas

Bastiaannet

Craen

et al. 2015

European Journal of Cancer

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“…Older women are less able to tolerate surgery than younger women because of increased likelihood of comorbidities,22 so overdiagnosis and overtreatment have a greater effect on their quality of life and physical function. This information should be made available to women considering screening.…”

Section: Effects Of Extending Age Rangementioning

confidence: 99%